Abstract P6-09-03: Examining recollections of Black women with breast cancer who participated in clinical trials: A grounded practical theory study of patient-provider communication
Authors: Precious Okoruwa, Katherine E. Ridley-Merriweather
Journal: Cancer Research (2023)

Abstract Introduction: The presence of strong barriers to research participation for Black and Brown women is indisputable. However, existing evidence clearly supports the possibility of equal levels of participation among members of minoritized populations in past breast cancer clinical trials, demonstrating that while these participation barriers do undoubtedly exist, they are not always insurmountable. A main implication of this current study is that researchers should take greater strides to remove the onus of recruitment responsibility from racialized population members, and instead leave it with the providers, investigators, and health care teams who hold enough power to make change. Purpose: This project takes a grounded practical theory (GPT) approach to engage with Black women who have been diagnosed with breast cancer and have participated in a breast cancer clinical trial and explores their recollections of conversations with their providers. GPT focuses on reconstructing particular communication practices, highlighting both the important procedural role of communication in practice and its ability to present intricate complications that echo society’s norms and values. The aim of this work is to investigate and analyze those patient-provider conversations to try to illuminate how providers can better engage these women in ways that will positively influence their perceptions of breast cancer clinical trial participation. Methods: The current study was part of a larger project examining the recruitment of Black women to breast cancer clinical trials. Fourteen women (N=14) from six different states in the U.S., all of whom self-identified as Black, Black American, or African American, agreed to be interviewed as part of a larger study. All participants had participated or were currently participating in a breast cancer clinical trial. The interviews yielded a wealth of interesting and potentially important additional data about Black female breast cancer patients and their communication experiences with their providers. Employing grounded practical theory as a framework helped increase insight into the patient-provider communication needs of Black women who have participated in a breast cancer clinical trial. Results: Findings were summarized into four categories: 1) the participants held differing perspectives and personal impressions toward their providers; 2) the women reflect on their individual breast cancer journeys through richly described incidences, describing searching for, and finding trials on their own, or being guided by healthcare providers who suggested a clinical trial for them; 3) each participant’s shared details of their unique communication relationship with medical and research providers; and 4) the cultural aspects of participants’ patient-provider communication, focusing primarily on their expressions of faith. These findings have important implications for health communication scholars, healthcare providers, and breast cancer clinical trial research principal investigators and team members. Conclusion: As opposed to the conclusion that one may draw from most published explanations of poor minority accrual to clinical trials, which appear to put the blame on the minoritized population members themselves, the current work outlines the actions and non-actions of many providers, and suggests that adjusting to approaches that demonstrate more encouragement and acceptance of their patients might result in better clinical trial participation outcomes from these group members. Citation Format: Precious Okoruwa, Katherine E. Ridley-Merriweather. Examining recollections of Black women with breast cancer who participated in clinical trials: A grounded practical theory study of patient-provider communication [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-09-03.